My ADHD Medication Journey: Making My Way All Over the Map

The question of whether or not one decides to take medication to treat their ADHD symptoms is both deeply personal and highly controversial. It seems as though everyone has an opinion on the matter, regardless of their level of personal experience with ADHD. On one side of the spectrum are those who are forcefully against any pharmacological treatment for the disorder. People in this camp tend to be deeply mistrustful of pharmaceutical industry and have a limited awareness of what ADHD is, not appreciating its physiological dimensions. All the way on the other side of the spectrum are those who advocate for the use of medication as the primary, and often only treatment of individuals with ADHD. They view medication as an ADHD “cure,” or as a quick and easy fix to the problems ADHD causes in the lives of those who have it, as well as those close to those who have it.

My own ADHD medication journey has been complex, as I, in typical ADHD fashion, have vacillated between each of these extreme poles since receiving my diagnosis when I was 17 years old. Years prior to getting diagnosed with ADHD I had been diagnosed with and medicated for depression and anxiety. In retrospect, I suspect much of my depression and anxiety as a teenager stemmed from my ADHD. However, it wasn’t until my sophomore or junior year in college, about three or four years after receiving my original ADHD diagnosis, that I decided to give ADHD medication a try. I think I put off going on ADHD medication because I was unconvinced of the legitimacy of ADHD as a real disorder, and regarded it more as a made up medical excuse for my disorganization, procrastination, lethargy, and laziness.

In college, I decided to go on psycho-stimulants to treat my ADHD symptoms.

I’m not clear on what precipitated my change of mind, but in college I decided to see a psychiatrist for my ADHD symptoms and was proscribed the amphetamine and dextroamphetamine combination medication Adderall. Psycho-stimulants like Adderall stimulate activity in the cerebral cortex by balancing the levels of the neurotransmitters (chemical messengers) in the frontal lobe of the brain and in other centers concerned with arousal and attention. I remember experiencing an immediate, marked increase in my ability to focus and resist distraction. I could suddenly spend hours in the library, studying productively. I could decide to clean my room and, within an hour, thoroughly complete the task. I even made straight A+s one semester. For a time, I was a ADHD medication convert.

The version of Adderall I was proscribed was Adderall XR, which is a once daily extended-release medication that lasts in one’s system for 10 to 12 hours. I soon realized that if I woke up at 8 AM and had classes or worked on campus until about 6 PM, the medication was nearly out of my system by the time I sat down to study. I felt I didn’t need the Adderall’s effects to attend classes or work my on campus job, and so, without consulting my psychiatrist, I began to put off taking the medication until I was done with those responsibilities. This often meant I would take the medication late in the afternoon, resulting in me staying up through the early hours of the morning, and sometimes all night, studying. I also found that the medication made me lose my appetite, which for a time appealed to me from both a weight loss and productivity perspective. If I didn’t get hungry, I didn’t have to interrupt my studies to go to the cafeteria. Soon I was sleep deprived and undernourished. I was also, unsurprisingly, extremely irritable and short with my friends, boyfriend, and sister, all whom were attempting to support me. And while my ability to focus had improved, the medication was doing nothing to improve my self-esteem, decrease my perfectionism, or address my lack of self-knowledge.

While ADHD medicine helped me to focus, my misuse of it resulted in significant negative side effects.

One night, after staying up to the wee hours of the morning studying for an International Relations final, I took what was meant to be a few hours nap and ended up sleeping through it. That mishap shook me sufficiently enough to make me realize just how unhealthy and out of control my Adderall use had become. I didn’t like feeling so tired, cranky, and anxious, and I didn’t trust myself to use the medication responsibly. Soon thereafter, I decided to stop taking my Adderall and to give up on ADHD medication altogether.

Partially thanks to the boost that Adderall gave my grades, I ended up graduating from college magna cum laude. Five years later I decided to apply to law school. I scored well on the LSAT and chose to attend UCLA Law. However, I never felt the same passion or excitement in law school as I felt as an undergraduate, and my ADHD symptoms made my law school experience extremely difficult. At this time in my life I was also experiencing a spiritual awakening of sorts. I was attending services as at spiritual center in Los Angeles, developing a meditation practice, and embracing Los Angeles’ alternative, new age culture. I felt unsuccessful and out of place in law school, and I was beginning to sense that Spirit had other plans for me. When a thirty-year-old friend of mine passed away from stomach cancer just months after being diagnosed, near the end of my first year of law school, I couldn’t bring myself to continue one day longer. I felt what I have now come to understand to be a common sensation for ADHDers: the need to run away, and fast.

Understandably, my family was very concerned for me. I had worked my behind off in college and in studying for the LSAT, not to mention throughout the first year of law school itself, and I seemed to be throwing it all away. What’s more, I had gone through that year of law school without receiving any support for my ADHD. I was unmedicated, not in therapy, and observably depressed. In reflecting on this time in my life, I found this email my father sent me when I decided to drop out of law school. I’ve decided to include it in this post because I believe the frustration that is palpable in his words will feel familiar to a lot of people who have love ones that suffer from ADHD.

Dev, I love you so much. I hate that you are feeling overwhelmed, depressed and scared for your future. I can only imagine your pain and disappointment. You know that you have my support no matter what direction you choose to take.

I believe that now, at this time, your decision making is being hampered by depression. It’s bullshit to not accept this and realize this fact. You have been gifted with many talents including brains, beauty, integrity, and athleticism, but more importantly a great heart and soul. You have proven yourself many times over, showing your goodness and compassion with your career choices up until now.

But, you are not perfect. Your refusal to acknowledge your ADHD and deal with it, is, I believe, the main reason you’re in so much pain now. I know multitudes of amazing people, successful and otherwise, not just in our family, who have similar handicaps. Both your mother and I have spent our entire lives dealing with our personal chemistry.

It is time for you to acknowledge your issues and deal with them with therapy and meds. I do not care if you become a lawyer or not. I have full faith that you will find your path and have a fulfilling life, but only if you deal with your issues medically. There is no yogi, guru, diet, etc., that will do this for you. You have some f*cked up reasoning that is not allowing you to take meds and to try to find a chemical answer. There is no rational excuse to not try the drug therapies that are available. You need to give yourself a chance to not only be successful in your career but to be happy. Do you have any idea how many times I have heard from both you and your mom, “I have never been really happy?” WTF. That never ceases to break my heart. It is not an unreasonably expectation, happiness, although maybe not as a first year law student. Happiness with you and your life may not be available without some help. Until you understand and accept this, you haven’t given yourself a chance to find it. I don’t know why you developed this animosity towards drug therapy for yourself, but I believe that you accept and acknowledge that it’s changed the lives for millions of people for the better. So once again, WTF.

Dropping out could be the correct answer. But quitting without having dealt with your depression and organizational handicaps is bullshit. There are thousands of people who will find lawschool easier than you. That doesn’t make them natural leaders like you. The degree doesn’t give them integrity, nor the ability to have people trust and follow them, as people trust and follow you. Either finish or take a medical leave, but don’t leave feeling like a failure because that’s the real bullshit here. The system sucks, your personal chemistry sucks, but you are and incredibly successful, proven person, who I believe is in a depressive funk and can’t see the forest from the trees.

Love always,

Dad

Honestly, despite my unwillingness to acknowledge them at the time, my father made a lot of legitimate points here. I agree with him that by refusing to get support for my ADHD while in law school, I never gave myself a chance to be successful there. However, I wonder how much of unwillingness to seek treatment lay in my attitude towards ADHD and its medications, and how much of it was a symptom of the ADHD itself. I found, and still find, navigating my way through the health care system in the United States to be overwhelming. When I gave up on Adderall in college, I did so without the guidance of a psychiatrist, partially because I just couldn’t get it together to keep track of my insurance information, and to make or keep the appointments.

Furthermore, in leaving law school I was attempting to find my way to a career and lifestyle for which I was better suited. That journey continues today. While I often wonder where I would be if I had taken my ADHD more seriously earlier in my life and showed more persistence in following through on receiving treatment throughout college, law school, and the different careers I have pursued, I also have a lot of gratitude for finding myself where I do today. Perhaps my unwillingness or inability to get the support I needed to be successful in my previous paths is the very reason I am today able to envision and begin to manifest a life that better suits my natural brain chemistry.

My ADHD medication journey is not over. After all the research I’ve done on the disorder, I am not ideologically married to either side of the ADHD medication divide. Depending on my future goals, I may very well decide to work with a psychiatrist to find a medication and dosage that works for me to help alleviate some of my ADHD symptoms. Just as important, however, is the work I’ve done and continue to do in therapy to address the inner pain and emotional hurt that ADHD has caused me with regards to my self-esteem and relationships, as well as the proactive decisions I’ve made to create a life for myself that is better aligned to my unique constellation of strengths and weaknesses.

What about you? Where are you on your ADHD medication journey? Have you decided to try medication to address some of your ADHD symptoms? How has it helped you, and what side effects have you experienced? What other treatments have you undertaken? I’d love to hear from you in the comments below.

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10 Comments

Dianne
on September 19, 2017 at 6:39 am

Great post . . . It’s a gift to watch you investigating this. Love you sweetie!

First of all, I haven’t had the chance to tell you yet how much I appreciate that you’re doing this blog! I’m trying not to blame myself too much for failing to do the deep introspection and investigation you’re doing here, but I really admire it.

SO many parts of this post resonate with me. I have gone on and off meds throughout different periods in my life since being diagnosed in 9th grade. I think I needed them most in grad school because I simply couldn’t afford to be so inefficient with my time. I remember my psychiatrist telling me, wait and see, when you’re out of school and in the working world it will be different. You won’t be pulling 16 hour days on the regular, pushing through sleepless nights, you’ll be more engaged working with others rather than spending hours alone with your books, etc. And you know what? He was right. The past five years I have been off my meds and doing pretty well in that regard. Now that I am back in the US, working remotely, alone, without structure, and often from home or a coffee shop, I am struggling big time. The pressure to produce is greater because my output is all I have to show for myself; the process no longer matters. The distractions only compound that stress and I am working longer hours out of the guilt I feel for not performing up to my own standards. This chews into working out time, cooking, exploring my new surroundings, and time with my partner. Not to mention relax/meditate which is the worst catch-22. I might need a better long-term solution, but right now I feel like I don’t have time to look for it! I plan on going back on meds to get through this transition and take it from there. I really appreciate reading your thoughts on the matter and not feeling like this is a copout move!

There are so many other things I wish we could discuss over a beer, like the expectations of loved ones, how they felt about who I was on/off my meds, not to mention how my mood would change – on an off day I often felt like a different person altogether. Lots to unpack, but perhaps most important is to silence the noise and do what’s right for me.

Question for you – did you ever play around with taking the XR and regular Adderall to get the right amount of time you needed? I used to take Concerta in the morning and Ritalin in the evening to get me through. The flexibility to choose – is this a 4, a 12, or a 16 hour day – was really helpful.

Jenny, so great to hear from you. One of the most gratifying parts of this blogging journey I’m on is connecting with other woman from throughout my life who also have ADHD and can relate with some of my struggles. I was checking out google analytics earlier today and saw someone was reading my blog from Tanzania. Was that you, or are you back stateside now?

I’m finding the questions about the effects ADHD has had on my relationships with loved ones to be the most painful to unpack. I still have a lot of pain there, and I haven’t done as much as I would like to proactively heal some of the hurt that my ADHD symptoms may have caused. I’m also finding it easier to attribute some of my career shortcomings to ADHD than I am to attribute my relationship shortcomings to it. It’s so hard to know what is ADHD and what is just me being an asshole.

As for playing around with different medication combinations to find the right fit–I honestly can’t really remember what I tried. Concerta sounds familiar, but it’s been so long since I’ve been on ADHD medication that I couldn’t tell you for sure if I tried it or not. What is certain is that I didn’t have the persistence to find the combination that worked for me. About a year ago I started seeing a psychiatrist again for the first time in years. I gave him my diagnosis paperwork and asked for ADHD medication, but he wanted to try me on Wellbutrin and see if that would help first (apparently Wellbutrin is used off label for ADHD). I didn’t notice much of a difference, honestly. These days I’m in Mexico, where, surprisingly, psycho-stimulants are more difficult to get proscribed than in the U.S. If/when I return to the U.S. and a regular work schedule, I’m pretty sure I’ll go down that path again.

The Adderall 5 mg IR works well for me. I like to ‘control the ride’ so being able to take small doses that don’t last long works well for my chemistry. Most docs don’t think of this tiny dose for adults but it’s all I need to become a productive and non-depressed earthling. YMMV.

From the first time the “idea” of medication came into play in my life, all i can remember was how against it my mom was- even at herself for being on them! Her opinion still haunts me today “you dont know what these pills are doing to you” “their poison to your body” and instead i was left to believe i was WEAK for resorting to them, as i was not “strong” enough to take care of myself in my own/in other ways.

When i went away to college, all hell broke loose in my mind. I got into the school i wanted, but it was a reach school for me, which shook my confidence and trust in myself when i couldnt keep up. My first visit home i collapsed into my moms arms as the uncontrollable anxiety took over my body. It was tough enough to see that my mom even gave me one her xanax! I instantly felt relief and wondered why this was such a taboo?? I hesitantly started medication, constantly questioning my decision to go down that road. If only it was really that simple to take a magic pill and feel better, like that first day. I wasnt prepared for the long road ahead of trial and error, adding and subtracting, and increasing and decreasing various medication combinations. I just wanted to help myself but constantly felt shame for doing so. But i did it anyway. Want to know why?

Since graduating and immersing myself in the world of autism professionally, i literally watched students transform for the better when the right medication was tried. Dont get me wrong, it wasnt rainbows and butterflies, i have seen what happens when the wrong meds are tried. But when it works, the proof is not only in the data, but i SAW it. They appeared calmer, more attentive and interested in learning and in us as their teachers! I realized it was because they were finally AVAILABLE to learn! No i dont think everyone needs medication, but when i saw real validation like that, i finally stopped feeling like what i was doing was so wrong. Nonverbal students began communicating effectively over the outburts and meltdowns. It was then i realized i wanted a better quality of life now. I need help, and theres no shame in trying to take care of yourself. (FYI this is of course in addition to behavioral therapy, but the focus of this post is medication)

Then a combination started working for me. Was i thrilled it took 5 different pills to do so? No. But i didnt know “what was wrong with me” and i needed help. I started thinking better, remembering things quicker- before the panic attacks and meltdowns. Why was i suffering so long? How could what i was doing be so terrible if it was helping me?? Well, unfortunately it got to a point where i was at the max dosage of concerta XR, and began abusing my short acting ritalin to compensate for the decrease in effectiveness. I had already been through adderall and vyvanse, had undesired experiences, and feared i hit the wall- what worked stopped working, and that bout of depression was probably the worst. What do i do now?? Why is EVERYTHING i do such a struggle?! Fastforward to last year, I found a new doctor, and i started all over. For the first time i heard, “you are not depressed” and i actually felt that way! Thats when ADHD really showed its face- and so the path continues..but im OKAY with it.

My mom unfortunately is having a really bad experience with medication she is trying to get off of- further validating her opinion against it. It is disheartening that she doesnt support what i need to do to better myself (in terms of meds) but i no longer beat myself up for it. I know in my gut im doing what i need, at least for right now, because to me it isnt worth living a life with all the stress i put on myself trying to fight back. But those negative thoughts never went away “youre weak, youre on meds because youre not strong enough to do it without.” At least now, with the help of therapy and meds, i am living a much happier life, that can only get better the more i continue to do the work. Instead of using my energy to beat myself up, im using it to make myself better!

Conclusion:
Medication is a personal decision. A decision that is not without challenges. But a decision that could potentially change your life when it feels like “all is lost.” Id like to think i wont need medication some day, but if thats not the case, thats okay too. You need to do what feels right for yourself, despite what others think (which for many of us is extremely important). I support ME, i support YOU if you go down this road, and i support your READERS, who may or may not decide to use medication. As long as you can find some means to an end, to ease the suffering, and live the life you were ment to live- happily 🙂

Sorry i didnt realize this would be so long (ADHD rambling lol) but thank you for your post, and for letting me get that out there!

Marissa,
So sorry I took so long to respond. I’ve recently made a move and had to put the blog on the back burner for a while. I love your comments and love that you seem to resonate with a lot of what I’m writing about. Yes, absolutely, we need to support every person’s autonomous decision around medication. There’s little that frustrates more more than folks who don’t understand ADHD passing judgement on the medication decisions of those of us who have it. I’ve heard judgement both against medication and against those who choose not to medicate, and both piss me off equally.
Again, thanks for your comments! Keep them coming, please.

Hi Ireally appreciate your witness… Itoo have had a spiritual awakening this year! An additional surprise that followed was my ADD diagnosis ( in Psychotherapy, 51 yrs old in Switzerlland )… I am taking Ritalin L 30 mg 4 times a day…it sounds less be a lot when I read other people talking about 10-40 msg daily, but I trust the Dr.and have kept an hourly protocol as the dosage was increased. Immediate release seems to have helped me more. Discussion Monday with Dr. if I am taking meds every 3 1/2 hrs why not immediate release. Your opinion?

Devon, my serial job hoppin’, wanderlust sister from another Mister.
Love reading your posts, but I need a way to connect with out outside of Facebook, as I plan to deactivate for awhile.

Regarding medication, I have recently started looking into Nootropics as an alternative solution. I think it would resinate with you as it does me, because like yourself, I fell into the love-hate relationship with my Adderall XR. It took me moving to Mexico, where its next to impossible to refill – for me to say thats it. I feel like I’ve detoxed. I return back to Ca in a few days and am looking forward to testing out alternative therapies without all the kick-back. Would love to share my findings..

So, tell me how we can connect outside of Facebook and I’ll meet ya there:-)